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[Risk factors of hypoxemia in patients admitted to intensive care unit after surgery]
Xunliang Li1, Man Chen1,2, Chunting Wang1,2
1Department of Critical Care Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China.
Objective:
To investigate the risk factors of postoperative hypoxemia in patients admitted to intensive care unit (ICU) for resuscitation.
Methods:
Clinical data of 220 postoperative patients admitted to the ICU for resuscitation in Shandong Provincial Hospital Affiliated to Shandong University from June to August 2020 were collected and retrospectively analyzed. According to their oxygenation index within 30 minutes after admission to ICU, they were divided into hypoxemia group (oxygenation index ≤ 300 mmHg, 1 mmHg ≈ 0.133 kPa) and non-hypoxemia group (oxygenation index > 300 mmHg). Baseline data and perioperative indicators were compared between the two groups, and risk factors for early postoperative hypoxemia were analyzed. The improvement of oxygenation index of patients with hypoxemia in next morning after admission to ICU was observed, and the factors related to the improvement of hypoxemia were analyzed.
Results:
The incidence of hypoxemia was 36.8% (81/220) in the cohort. The majority cases of hypoxemia were from general surgery department, accounting for 42.0% (34/81). The incidence rate of hypoxemia from orthopaedic was the highest at 53.3% (16/30). Univariate analysis showed that body mass index (BMI), intraoperative hypoxemia, minimally invasive surgery were all risk factors of postoperative hypoxemia (test values were -2.566, 12.352 and 0.033; P values were 0.010, 0.000 and 0.019, respectively). Multivariate analysis showed that intraoperative hypoxemia and BMI were independent risk factors for postoperative hypoxemia [intraoperative hypoxemia: odds ratio (OR) = 3.602, 95% confidence interval (95%CI) was 1.143-3.817, P = 0.001; BMI: OR = 1.119, 95%CI was 1.026-1.208, P = 0.036]. The improvement rate of hypoxemia next morning after admission to ICU was 63.0% (51/81). Pulmonary dysfunction was the independent risk factor for the improvement of hypoxemia (OR = 0.200, 95%CI was 0.052-0.763, P = 0.019).
Conclusions:
Hypoxemia might occur early after surgery. Intraoperative hypoxemia and BMI were independent risk factors for postoperative hypoxemia.
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